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UNIVERSITY OF EAST ANGLIA
School of Pharmacy
Main series UG Examination 2015-2016
OPTIMISING PATIENT CARE THROUGH PHARMACY
PHA-6002Y
Time allowed: 2 hours
Part ONE
Answer ALL questions. For each question, there is ONE correct answer. Use the
answer grid provided for ALL your answers.
Part TWO
There is ONE question in this section.
Part THREE
Answer ONE of the TWO questions in this section.
Use a SEPARATE answer book for EACH question from Parts TWO and THREE.
Each question has the same value.
The marks distribution is shown as a percentage for each section of the question.
Answer ALL parts of each of the individual questions you select.
The mark allocation for the paper is:
 Part ONE carries 50% of the total mark.
 Part TWO carries 25% of the total mark.
 Part THREE carries 25% of the total mark.
You are advised to spend no more than 60 minutes on Part ONE.
You are advised to spend approximately 30 minutes on Part TWO.
You are advised to spend approximately 30 minutes on Part THREE.
This paper consists of 14 pages in total.
The following will be provided: Multiple choice answer grid.
Notes are not permitted in this examination.
Dictionaries are not permitted in this examination.
Calculators are not permitted in this examination.
Do not turn over until you are told to do so by the Invigilator.
Do not take this question paper out of the examinations room.
(PHA-6002Y)
Copyright of the University of East Anglia
Module Contact: Mrs Laura Ellis, PHA
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PART ONE
SECTION A – TYPE 1 MCQs (Single Best Answer)
Answer ALL questions. Use the answer grid provided for ALL your answers.
1.
With regards to medicines for animal use which ONE of the following is
INCORRECT?
(A)
POM V medicines must be supplied in accordance to a prescription from a
veterinary surgeon
Pharmacists can prescribe POM VPS medicines
Suitably qualified persons can prescribe POM VPS medicines
Pharmacists can supply a human medicine for an animal provided it is
categorised as a GSL
Any retailer may supply AMV GSL medicines
(B)
(C)
(D)
(E)
2.
Mr LS is a 45 year old male with a BMI of 30. He has just been diagnosed with
type 2 diabetes. Which ONE of the following would be the most suitable
treatment for him?
(A)
(B)
(C)
(D)
(E)
Gliclazide
Insulin
Metformin
Ramipril
Sitagliptin
3.
A patient is prescribed prednisolone 5mg tablets, with a dose of 40mg for two
days, 30mg for two days, 20mg for two days, 10 mg for two days, 5mg for five
days then stop. How many 5mg tablets should you supply?
(A)
(B)
(C)
(D)
(E)
16
28
41
45
84
4.
Which ONE of the following is NOT a feature of an addictive drug?
(A)
(B)
The individual experiences the need to sleep when a dose wears off
The individual taking the drug craves another dose when the previous dose is
wearing off
The individual experiences withdrawal symptoms when the drug wears off
Withdrawal symptoms are relieved by a subsequent dose of the drug
The individual requires increasingly higher doses to obtain the same effect of
the drug
(C)
(D)
(E)
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5.
Which ONE of the following statements about a curriculum vitae (CV) is most
accurate?
(A)
When applying for several jobs applicants should produce a generic CV to
save time
Applicants should not ask anyone to proof read their CV as this amounts to
collusion
Applicants should include both positive and negative information in their CV to
present a balanced view
Most recruiters will spend an average of 10 seconds reading a CV before
deciding whether to shortlist
Inclusion of a detailed personal statement removes the requirement for a
covering letter
(B)
(C)
(D)
(E)
6.
Which ONE of the following is a SMART objective?
(A)
(B)
(C)
I will produce a health promotion leaflet
I will help 10 people quit smoking in the by the end of June
I will run a health promotion campaign on weight loss within the pharmacy in
June
I will counsel patients newly prescribed statins on diet to ensure they all eat 2
portions of oily fish per week
I will train the healthcare assistants on health promotion
(D)
(E)
7.
In order for a patient to make an informed decision which ONE of the following
is INCORRECT?
(A)
(B)
(C)
(D)
(E)
They should be able to understand the information provided
They should remember the information provided
They should have a written copy of all the information as reference
They should use and weigh up the information to make a decision
The patient must be able to communicate their decision
8.
A patient is admitted to hospital complaining of nausea and vomiting,
diarrhoea and blurred vision. Which ONE of the drugs below is most likely to
be the cause?
(A)
(B)
(C)
(D)
(E)
Diazepam
Digoxin
Diltiazem
Domperidone
Doxycycline
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9.
Which ONE of the following statements concerning mesalazine is
INCORRECT?
(A)
(B)
(C)
(D)
(E)
Its primary indication is for the treatment of inflammatory bowel disease
It is an aminosalicylate which has a systemic effect
Side effects include exacerbation of colitis
Patients require monitoring of renal function
Formulations include suppositories and enemas
10.
Which ONE of the following statements concerning sildenafil for the treatment
of erectile dysfunction is INCORRECT?
(A)
(B)
(C)
(D)
(E)
It works by increasing blood flow to the penis
It is contraindicated in patients receiving nitrates
It has an immediate action
Patients can take a maximum of one dose in a 24 hour period
Side effects include priapism and night sweats
11.
Which ONE of the following is NOT indicated for Asthma?
(A)
(B)
(C)
(D)
(E)
Beclomethasone
Fludrocortisone
Monteleulast
Salbutamol
Theophylline
12.
Which ONE of the following best describes effective delegation?
(A)
Delegation gives someone else accountability for a task which is not included
in their core job description
Delegation requires the person undertaking the task to follow step by step
instructions
Delegation gives someone else responsibility for a task which is not included
in their core job role
Delegation should only include tasks a person has undertaken previously
Delegation is only required when you are too busy to complete a task yourself
(B)
(C)
(D)
(E)
13.
Which ONE of the following statements concerning lipid lowering drugs is
INCORRECT?
(A)
(B)
(C)
(D)
(E)
Simvastatin is first line treatment for hypercholesteroleamia
Ezetamibe can be taken in combination with Simvastatin
Ezetamibe inhibits intestinal absorption of cholesterol
Simvastatin competitively inhibits HMG-CoA reductase
Grapefruit juice should be avoided in patients taking Ezetamibe
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14.
Which ONE of the following statements concerning the supply of nonmedicinal poisons and explosive precursors is CORRECT?
(A)
(B)
Part 1 contains regulated non-medicinal poisons
In order to purchase a reportable substance the purchaser requires a Home
Office licence
Supplies of regulated substances can be made to a third party provided they
provide the purchasers license and passport
Supplies of regulated explosive precursors must be recorded in the poisons
register
All supplies must be labelled with the words ‘Acquisition, possession or use by
the general public is restricted’
(C)
(D)
(E)
15.
Which ONE of the drugs below should have ‘Warning: Do not drink alcohol’
included on its dispensing label?
(A)
(B)
(C)
(D)
(E)
Amoxicillin
Clarithromycin
Doxycycline
Metronidazole
Trimethoprim
16.
Which ONE of the following is NOT legally required on a prescription for a CD
POM issued by a veterinary surgeon?
(A)
(B)
(C)
(D)
(E)
Prescribers RCVS number
Dose must include a number
“For an animal under my care”
Total quantity in words and figures
Telephone number of veterinary practice
17.
Which ONE of the following tasks would be the most important and urgent
task according to Covey’s time management matrix?
(A)
(B)
(C)
Checking the weekly cashing up
Denaturing patient return controlled drugs
Speaking to a member of the local CCG who has just come into pharmacy to
discuss potential health promotion campaigns for the upcoming year
Speaking to the local GP on the telephone concerning an issue with a patients
prescription
Packing up the previous months prescriptions to send to the NHS BSA
(D)
(E)
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18.
Mr TY brings in the following prescription for a CD POM on an FP10MDA into
your pharmacy which opens Monday to Saturday
Methadone mixture 1 mg/mL
30 mL daily supervised
‘Instalments due on days when the pharmacy is closed should be
dispensed on the day immediately prior to the closure’
Which ONE of the following is appropriate regarding supply to Mr TY?
(A)
(B)
(C)
(D)
(E)
Supply sugar free methadone on each occasion
Take half the dose in the pharmacy and take the remainder home
Take Sunday’s dose home on Saturday
Supply the methadone after he has missed five days supply
Take methadone home on days when the pharmacy is busy
19.
You are working on a hospital ward and conduct a medication history with Mr
FG who tells you that he uses latanoprost eye drops but cannot remember
what it is used for.
Which ONE of the following is the usual indication of latanoprost?
(A)
(B)
(C)
(D)
(E)
Allergic conjunctivitis
Bacterial conjunctivitis
Blephoritis
Glaucoma
Inflammation
20.
Mrs CF comes into your pharmacy for an MUR, and explains that she has not
been feeling tired and had very cold hands recently. Which ONE of the
following medicines on her PMR is most likely to be associated with these side
effects?
(A)
(B)
(C)
(D)
(E)
Atenolol
Bendroflumethiazide
Chlorphenamine
Nicorandil
Temazepam
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21.
(A)
(B)
(C)
(D)
(E)
22.
(A)
(B)
(C)
(D)
(E)
23.
(A)
(B)
(C)
(D)
(E)
24.
(A)
(B)
(C)
(D)
(E)
You are working in medicines information when you get a call from an FY1
doctor working on an elderly ward. He has a patient with Parkinson’s Disease
who requires an anti-emetic. Which ONE of the following is the most
appropriate?
Amitriptyline
Domperidone
Metoclopramide
Ranitidine
Sumatriptan
A 5 year old child is prescribed paracetamol oral suspension 120mg/5mL at a
dose of 240mg QDS for 4 days. Which ONE of the following is the correct
volume to supply?
80 mL
100 mL
160 mL
200 mL
240 mL
Miss KL telephones your pharmacy for advice, she explains that she usually
takes Cerazette® a progesterone only oral contraceptive pill containing
desogestrol at 10 pm. Last night she forgot to take her pill and had sexual
intercourse. She took her missed pill at 8 am once she remembered. Which
ONE of the following is the most appropriate recommendation?
Seek emergency contraception
Take a double dose of Cerezette® at 10 pm tonight to ensure contraceptive
cover is maintained
Continue to take your Cerazette® as usual, but use condoms for the next
seven days
Nothing, continue as usual as contraceptive cover is maintained if the pill is
taken within 24 hours of its usual time
Nothing, continue as usual as contraceptive cover is maintained if the pill is
taken within 12 hours of its usual time
Mr TG is newly prescribed Warfarin following a deep vein thrombosis, which
ONE of the following over the counter preparations should Mr TG avoid whilst
on his treatment?
Chlorphenamine
Co-codamol
Ibuprofen
Loratidine
Senna
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25.
Which ONE of the following verbal responses is most appropriate when
dealing with a difficult patient?
(A)
(B)
(C)
(D)
(E)
Passive
Manipulative
Aggressive
Assertive
Reactive
26
Miss TY calls into your pharmacy and asks you to recommend something for
her as she is feeling run down and has a sore throat and mouth ulcers. She
hands you a list of her regular medicines. Which ONE of the following drugs is
most likely to be associated with Miss TY’s symptoms?
(A)
(B)
(C)
(D)
(E)
Carbimazole
Metformin
Paracetamol
Prednisolone
Ramipril
27.
Which ONE of the following statements regarding the destruction of Schedule
2 controlled drugs by a pharmacist is CORRECT?
(A)
A pharmacist may destroy expired pharmacy stocks without the presence of
an authorised person
A pharmacist may accept and destroy stocks returned by a patient without the
presence of an authorised person
A pharmacist may accept and destroy stocks returned from a nursing home
without the presence of an authorised person
A pharmacist is legally required to record in the CD register stocks returned by
a patient
Records of destruction of stocks are legally required in the POM register
(B)
(C)
(D)
(E)
28.
A medicine label states: ‘swallow whole, with a full glass of water. Take on an
empty stomach and remain sitting or standing for at least 30 minutes after
taking.’ Which ONE of the following drugs is this applicable to?
(A)
(B)
(C)
(D)
(E)
Alendronic acid
Ferrous sulphate
Levothyroxine
Phenoxymethylpenicillin
Tamsulosin
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29.
You receive the following prescription for a CD No Reg POM in your
pharmacy:
28 Temazepam 10mg tablets 1 PRN
Which ONE of the following concerning the supply is INCORRECT?
(A)
(B)
(C)
(D)
(E)
The prescription is valid for 28 days
The total quantity must be in words and figures
A dose of 1 PRN is NOT acceptable
You should recognise the prescribers signature
NFA as an address is acceptable
30.
You receive the following prescription for a CD POM in your community
pharmacy:
10(ten) Fentanyl transdermal patches
Apply one every three days
You notice that the strength is missing from the prescription. Which ONE is
the most appropriate course of action?
(A)
(B)
(C)
(D)
(E)
Supply the prescription based on the PMR
Contact the prescriber to confirm the strength, then endorse the prescription
‘PC’ and the strength and endorse the amendment with your initials and date
Contact the prescriber to confirm the strength, supply the patient then return
to the surgery for amendment
Return the prescription to the prescriber for amendment prior to supply
Send the patient to another pharmacy
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SECTION 2 – Type 2 MCQs (Extended Matching Questions)
Answer ALL questions. Use the answer grid provided for ALL your answers.
Questions 31 to 34 relate to the options below, please select ONE answer per
question.
Anti-infective Medicines
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
Aciclovir
Amoxicillin
Cefalexin
Chloramphenicol
Clarithromycin
Fluconazole
Mebendazole
Mefloquine
Metronidazole
Trimethoprim
For each statement select ONE answer. Each option may be used once, more
than once, or not at all.
31.
Is the most appropriate drug to treat a patient with upper respiratory tract
infection who has previously developed an itchy rash whilst taking
phenoxymethylpenicillin.
32.
Is available as a single dose tablet to treat vaginal candidiasis.
33.
Is contra-indicated in patients with a history of psychiatric disease.
34.
Is associated with ‘grey baby syndrome’.
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Questions 35 to 37 relate to the options below, please select ONE answer per
question.
Cardiovascular medicines
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
Amiodarone
Amlodipine
Bendroflumethiazide
Bisoprolol
Digoxin
Diltiazem
Furosemide
Isosorbide mononitrate
Losartan
Ramipril
For each statement select ONE answer. Each option may be used once, more
than once, or not at all.
35.
Is most appropriate for a 58 year old who has blood pressure of 150/95 and
no other medical conditions.
36.
May lead to tolerance if taken long term, which can be avoided by asymmetric
dosing.
37.
Is a suitable alternative for a patient who had developed a cough whilst
taking Lisinopril.
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Questions 38 to 40 relate to the options below, please select ONE answer per
question.
Formulary Medicines
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
Amitriptyline
Codeine
Diazepam
Fentanyl
Ibuprofen
Paracetamol
Morphine
Naproxen
Sumatriptan
Temazepam
For each statement select ONE answer. Each option may be used once, more
than once, or not at all.
38.
Is a 5-HT receptor agonist.
39.
Is indicated for migraine prophylaxis.
40.
Is indicated in patients with muscle spasms.
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PART TWO
There is ONE question in this section. Use a SEPARATE answer book for this
question.
41.
Answer BOTH questions.
You are the pharmacist manager of a busy community pharmacy, who
employs four additional members of staff.
Name Details
L
Experienced NVQ level 3 dispenser works part time 10-3 on Mondays,
Tuesdays, Thursdays and Fridays. Most time on Mondays and Tuesdays is
spent dispensing MDS for local care homes.
A
Just completed NVQ level 3, works full time, but has Wednesday afternoons
off in lieu of Saturday morning. Mainly works in the dispensary but covers
MDS on a Wednesday morning.
P
Completed level 2 in pharmacy services, keen to progress onto level 3.
Works full time Monday to Friday. Works in dispensary and helps on the
counter when it’s busy.
K
Medicines counter assistant, just started level DAC. Works Monday to
Thursday and Saturday mornings, mainly responsible for front of shop and
medicines counter but works in dispensary on a Wednesday.
Below is a copy of the pharmacy near miss log for the past two weeks which
has seen a significant increase in the number of recorded events.
Error
Staff Details
Code
Mon 1st
09:30 Amoxicillin
L
A
Incorrect directions
nd
Tues 2
14:30 Betnesol eye drops
O
L
Expired
Wed 3rd
11:00 Nifedipine
D
K
Nicorandil selected
rd
Wed 3
14:15 Trimethoprim
Q
K
Part pack
Wed 3rd
15:00 Ramipril
L/F
K/P
Tablets not Capsules
Thur 4th
14:00 Furosemide
Q
L
Part Pack
th
Thur 4
16:45 Seretide
D
P
Serevent selected
Fri 5th
17:50 Simvastatin
S
A
40mg not 20mg
th
Sat 6
11:30 Timolol eye drops
O
A
Expired
Mon 8th
09:15 Salmeterol
F
P
Accuhaler not evohaler
th
Tues 9
13:30 Co-codamol
Q
L
Part Pack
Wed 10th 10:15 Budesonide
D/F
K
Symbicort selected
th
Wed 10
14:00 Erythromycin
L
K
Incorrect directions
Wed 10th 15:40 Bendroflumethiazide L
K
Incorrect directions
th
Fri 12
09:50 Metronidazole
Q
P
Part Pack
Sat 13th
12:50 Simvastatin
S
A
20mg not 40mg
Error code: D=wrong drug; F= wrong form; Q= wrong quantity; S= wrong strength;
O=Out of date; L=labelling error.
Date
(a)
(b)
Time
Drug
Analyse the information provided and identify any factors which may have
contributed to the near misses recorded in the log
[70%]
Describe the actions you would take as pharmacy manager to reduce the
number of near misses recorded within your pharmacy
[30%]
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PART THREE
Answer ONE of the TWO questions in this section. Use a SEPARATE answer book
for this question.
42.
You are working in a community pharmacy on a Saturday afternoon when you
receive a telephone call from Mrs Francis, she explains that her husband has
run out of his MST 30mg tablets, she thought that he had another packet. He
is a regular patient and an extract of his PMR is given below.
Mr Edward
Francis
Date
20/05/16
15 Home
Avenue
Flatplace
Quantity
300mL
20/05/16
19/04/16
19/04/16
19/04/16
500mL
60
14
300mL
19/04/16
19/04/16
56
56
16/02/1946 (70 years)
Drug
Morphine Sulphate Oral
solution 10mg/5mL
Lactulose solution
MST 30mg tabs
Temazepam 10mg tabs
Morphine Sulphate Oral
solution 10mg/5mL
Amlodipine 10mg tabs
Atorvastatin 20mg tabs
Dr Thompson
Flatplace medical
practice
Dose
5-10 mL PRN
15 mL BD
1 BD
1 ON PRN
5-10 mL PRN
1 OD
1 OD
Describe the process that you would go through when considering this
request, differentiating between legal, professional and clinical considerations
and your course of action.
[100%]
43.
During an MUR with a patient with Cardiovascular disease the patient
confides in you that they are buying Viagra on-line and doesn’t want to tell
their GP.
Describe the process that you would go through when considering this
request, differentiating between legal, professional and clinical considerations
and your course of action
[100%]
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